Recurrent discitis in the acute rehab setting: a case report.

Spinal Cord Ser Cases

1Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, USA.

Published: March 2018

AI Article Synopsis

  • Discitis is a serious infection of the spinal disc space that can cause severe complications if not treated promptly, often presenting with vague symptoms and limited lab abnormalities.
  • A case study is presented involving a 67-year-old woman with a history of discitis, who experienced sudden severe back pain despite treatment, leading to further investigation despite normal vital signs and labs.
  • The discussion emphasizes the importance of recognizing recurrent discitis in patients with past infections, even when typical signs of infection are absent, and stresses the need for careful monitoring and additional tests like inflammatory markers in such cases.

Article Abstract

Introduction: Discitis is an infection of the intervertebral disc space that can lead to paralysis, sepsis, epidural abscess, or other life-threatening complications if left untreated and may sometimes present with limited laboratory abnormalities to clue a diagnosis.

Case Presentation: We present a case of a 67-year-old female in an acute rehabilitation setting who had presenting symptoms of sudden unexplained back pain refractory to pain control. She had a previous history of discitis and multiple failed knee replacement surgeries secondary to MSSA infections. Although vitals and basic labs were within normal limits, we recognized the clinical presentation as an indicator to order inflammatory markers (CPR and ESR), which were elevated compared to levels on admission, and subsequently ordered imaging and blood cultures to detect a case of recurrent worsening discitis.

Discussion: We highlight the presentation of recurrent discitis and necessary low threshold needed to detect such recurrence in patients with a previous history of discitis that have sudden unexplained back pain with no other usual physical or laboratory indicators of infection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862829PMC
http://dx.doi.org/10.1038/s41394-018-0052-0DOI Listing

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